Class Action Settlement Tied to $1B Investment in Moving Nursing Home Residents to HCBS

One state has committed more than $1.1 billion to boosting community living options for people who would otherwise be in a nursing home, following a landmark class action lawsuit settlement. The 54-page settlement agreement still needs a judge’s approval.

The original case, titled Marsters v. Healey, involved six residents who were unable to leave their nursing facilities to rejoin the community, with a lack of support from the Commonwealth of Massachusetts cited as the main reason for their inability to leave.

These residents, along with the Massachusetts Senior Action Council, sued the state in 2022, alleging the state was violating the Americans with Disabilities Act (ADA) by unnecessarily placing people with disabilities in a nursing home rather than providing home- and community-based services (HCBS), according to reports from the Boston Globe.


The U.S. Department of Justice is also investigating whether the state violated the ADA as a result of not transitioning people with disabilities from nursing homes to community settings.

This type of lawsuit is nothing new for the state, according to the Globe, with suits filed under previous governors in 1999 and 2009, resulting in the transition of thousands of people with brain injuries and intellectual and developmental disabilities from nursing homes into community settings.

As part of the settlement and subject to court approval, the Massachusetts Executive Office of Health and Human Services will invest upwards of $1 billion over the next eight years – in particular, targeting the transition of at least 2,400 residents with disabilities from nursing homes to community settings, reports said. Funds are available through the American Rescue Plan Act.


Rental vouchers will be made available to those with disabilities seeking to live independently and establish new residential settings, according to a statement from Gov. Maura Healey. Funds will be earmarked to add beds to group homes, with 800 new subsidized housing opportunities, the Globe reported.

Tara Gregorio, president of the Massachusetts Senior Care Association, which represents nursing homes, said the state has been and remains the entity solely responsible for determining criteria for clinical admission into a nursing facility, to receive long-term care Medicaid services.

“We continue to support and collaborate on efforts to ensure residents have access to safe discharges to the community,” said Gregorio. “Nursing facilities provide a vital service to frail elders and disabled individuals who can no longer be cared for safely at home, and it is critical that these core services be fully funded to ensure quality resident care and to allow us to continue to invest in our dedicated and diverse workforce.”

The commonwealth has also designated teams to engage with nursing home facility residents and help them make an informed choice about opportunities to receive services in the community. MassHealth’s Money Follows the Person Demonstration was renewed as well, which identifies and supports the transition of individuals in nursing facilities to community-based settings.

Along with these changes, Massachusetts is increasing the capacity of MassHealth Moving Forward Plan waivers, which provides supportive services in group homes and in a person’s own home; these individuals would otherwise require services in a facility-based setting.

Those with mental illness will receive enhanced care coordination while they’re in the nursing facility to make sure they receive needed specialized services and can be discharged from the nursing facility as soon as possible, according to Gov. Healey’s office.

Plaintiffs Lorraine Simpson and Richard Caouette shared their reactions to the settlement and an excitement to live a life closer to the community in a statement released by Gov. Healey’s office.

“After leaving Jamaica 20 years ago, I lived independently in my own apartment, was connected to my children, and enjoyed cooking and caring for others. But for the past two years, I have been confined to a nursing facility where I can’t do anything for myself,” said Simpson. “Because of the Agreement, I will have a new home in the community near my family and friends. I can’t wait to take care of my own home, spend time with my family, and cook for them again.”

Caouette said he lived an independent life as a U.S. Army veteran prior to being admitted to a nursing home.

“For me, living in a nursing home is like living under martial law. I am determined to return to the community and pray the Agreement will get me a new home so I can leave here,” Caouette said in a statement.

The lead plaintiff, John Simmons, died in the nursing home, waiting to be moved to a more community-focused setting.

The Executive Office of Health and Human Services currently spends more than $5.8 billion through MassHealth and HCBS waivers annually on long-term services and supports in the community, according to Gov. Healey’s office.

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